Diagnosing a fatigue illness in a teenager

We all know that many teenagers spend a lot of time sleeping. This is not an illness, this is a fact of rapid growth, biorhythms and stress that characterize adolescence. But what if your teen can't get out of bed? Misses school for days, weeks, even months at a time? Complains of vague aches and pains, but never seems to be REALLY sick? He or she could be suffering from adolescent (or childhood) onset FMS or CFS. Truly, it is hard to know.

The diagnostic criteria for FMS, according to the Mayo Clinic, FMS can be diagnosed by presence of 11 0f 18 tender points on the body. There are a number of other symptoms that may or may not be present as well, including:

v    Chronic headaches

v    Migraines

v    Vague aches in arms and legs

v    Sore throats

v    Low-grade fevers

v    Hair loss

v    Weight gain

v    Sleep disorder and non-restorative sleep

v    Fatigue

v    Depression

v    Bladder/bowel pain, urinary frequency

v    Sensitivity to light and/or sound

v    Jaw clenching/TMJ

With teenagers, it's a little more complicated. Very often the main diagnostic symptom of pain in specific places is not present. This fact creates a very confusing picture for both parents and physicians, often leading to misdiagnosis, non-diagnosis and prolonged suffering. As with adult onset FMS or CFS, the illness can follow a specific stressor or more severe illness, or a prolonged period of mild depression and /or vague complaints.

The unfortunate reality is that the diagnosis of FMS or CFS is something of a guessing game, and the guessing involves a process of elimination. (Headaches? Check iron, vision, allergies, blood pressure, etc. ) It is a laborious and frustrating process.

So, if your teenager is not getting out of bed, even for things they love to do, speak to your doctor. The doctor will order a series of standard blood tests, including thyroid function. Once the doc has eliminated any number of life-threatening or serious medical conditions, then we take the next step.

Next time: After the Diagnosis: Now what?